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In the 1920s Sir Frederick Banting, the inventor of insulin medication, sold the patent for one Canadian dollar. He insisted that the medication should belong to the world. Nowadays, the three pharmaceutical giants manufacturing insulin have no such humanitarian concerns. In the U.S., one gallon of insulin costs $113,000, according to the documentary Pay or Die. The price has skyrocketed by 300% over the past quarter century.
Directors Scott Alexander Ruderman and Rachael Dyer present the numbers through human stories. Among them is the mother who drives her 11-year-old daughter across the border to Canada where pharmacies dispense insulin at reasonable prices. “In Canada, prescription medicine is health care. In the U.S., it’s business,” explains a Canadian pharmacist. Much of the film concerns the Minnesota parents of Alec Smith, a young man who died from Type 1 diabetes because he rationed his insulin, stringing out the supply between paychecks. Although his parents had never been activists, his death thrust them to the forefront of a bill before the Minnesota legislature to provide support for diabetics in need. They found some support in high places, but faced healthcare industry lobbyists for whom the corridors of power are their natural habitat.
Testimony by a pharma trade association spokesperson at a hearing excerpted in Pay or Die illustrates the blame game. Big pharma accuses insurance companies and for-profit health networks for insulin’s sticker-shock price tag. They have a point: everyone along the supply chain profits—except the diabetics who need insulin to live.
Canada isn’t the only destination for America’s “medical refugees.” By one account, an insulin pen costing $8 in Taiwan sells for $180 in the U.S. It might almost be cheaper to fly coach across the Pacific to buy medication than to fill a prescription at home.
The idiocy of those who criticize every move to regulate healthcare as “socialized medicine” is plain to see in Pay or Die. Healthcare is already rationed for millions of Americans, based on how much they can afford to pay.
Pay or Die is streaming on Paramount +.
